1991, 04-26 Permit: 91002104 SewerSPOKANE COUNTY DEPARTMENT OF BUILDINGS
0C13D3BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
I certify that I have examined this permit/application, state that the informaiion contained in it and submitted by me or my agent to compile said permit/application permit/applicationtrue
and correct, and authorize SpokaCounty to u with processing In wm I have read and understandm/wSpscnownauomsmswTmwoncs
provisions included herein and agree to comply with same. All provisions of laws and ordinances governing this type of work will be complied with whether specified
herein or not. I understand that the issuance of this permit/applicationand any subsequent inspection approvals or Certificates of Occupancy shall not be construed to
give authority to violate or cancel the provisions of any state or local law regulating construction, or as a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF
OWNER 0nAGENT
`•
APPLICATION ' �
DATE
, ^
� �
PROJECT NUMBER=. 01,002iO4 ISSUEDPEpMIT DATE= 84/26/91 PAGE= ;i
**+****************fl**«*N** PERMIT lNF;RMA7IoN ************************4(:*
.
. SITE STREET= 204 H MOFFITT LN . PARCFL��� 1-6543-03i9
ADDQF�J= %P�K'uE,WA 9920'L . , . .,. � ' .. . .
PERMIT`U���=- SEWER CONNECTlnN -: :mor FI�iT PUD •. .
. . ' .
- '
' PLA.4= 81654 - PLAT NAME= -WAFFIT7'S SUB^R1114'/151 OPP, r
BLOCK= LOT= . 1 Z0@[= UR -12 8l%T4= F
AREA= F/A= FW�3TA= 38 DEPTAL 69 R/y= 24
�
OF DLV�= 4 DWELLINGS= ' i WATER." DIST = MODERN
OWNER=TUPPER- INC PHONE= 509 920 1991
%TREE?= 12929 E SPRAGUE AVE
ADDRESS=. SPOKANE WA 99216 .
CONTACT !AhE= KEN TUPPER PHDNE NUM/'ER= 509 928 1991
BUlLDING'%ETBACKC: FRONT= NA LEFT- NA • RIGHT= WA ' REAR= NA • '
***************************** %EWEK �PERmlT ******#***************»*******
'CONTRACTOR= COI'%EAL MECHANICAL I��C -.RHONE= 589 535 59-44
• ' ' STREET= 5524 EKD0NE AVE � ' '
ADBRES= SPOKANE WA 99212 . '
-ITEM DESCRIPTION OU4NTITY FEE AMOUNT
—`--`---- -------------- ---^---` —`-------
' PROCESSING FEE ' Y .-iO.08
- � ' 'SEWER CONNECTION � 1�
' � �� 4�^88
^- � , �
************.*****x****1;?******x* PAYMENT sUmMARY ****************************
PAYMENT ;ATE RECEIPT � ' PAYMENT AMO|�4T
`-
. 64/26/91 ' 2352` • 58'80 1
.------------
TOTAL DVE=. .8O TOTAL PAID= ^ : 50'88
PERMIT.TYPE- ' FEE AMOUNT ' AM;UNT- PAID AMOUNT OWING
SEWERPERMlT • - 58^88 - 50f88 - .08
- , � ---�-~._-'--- --'--------- - ". .. 58.08. 58'08 . ^08
PkOCE%%ED:R/: FORRy„ JEFF
PRINTED u,� rnpov JEFF
' `^'`'� �' '''"'/ !
****x********************«*«**** THANK YoU-*****«**************************«
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